Price data on Brockton hospitals called useless

The federal Centers for Medicare and Medicaid Services released 2010-2011 data showing how much hospitals in the Brockton region and nationwide charge for the 100 most common inpatient procedures and illnesses.

By Alex Bloom

The Enterprise, Brockton, MA

By Alex Bloom

Posted May. 12, 2013 at 12:01 AM
Updated May 12, 2013 at 12:10 PM

By Alex Bloom

Posted May. 12, 2013 at 12:01 AM
Updated May 12, 2013 at 12:10 PM

BROCKTON

» Social News

Academics say a new report on prices charged at various local hospitals for common medical procedures is confusing.

“This information is useless and misleading,” said Stuart Altman, a professor of national health policy at Brandeis University.

On Wednesday, the federal Centers for Medicare and Medicaid Services released 2010-2011 data showing how much hospitals across the country charge for the 100 most common inpatient stays for people on Medicare – which covered about 50 million people, primarily the country’s 65-and-older population, in 2012.

In Brockton, the data showed a wide range of charges – as much as a $74,000 difference – for the same procedures between Signature Healthcare Brockton Hospital and Good Samaritan Medical Center.

Brockton Hospital’s average prices were higher for 64 of the 70 procedures the two hospitals perform.

Signature Healthcare President and CEO Kim Hollon said the price differences do not affect the average patient at the 263-bed hospital.

“From the public’s perspective, (the data) provides more confusion than it does help,” he said.

The biggest difference in price was for treatment of septicemia – a life-threatening infection – requiring 96 hours of medical ventilation. Signature Healthcare Brockton Hospital, which treated the condition 12 times during 2010-2011, had average charges of $119,704, while Good Samaritan averaged $44,988 on 18 treatments – a $74,000 difference.

The two city hospitals were the closest in prices for treatment of seizures without major complications or co-morbidities (the presence of one or more other disorders or diseases), with Good Samaritan averaging $7,723 on 30 cases during 2010-2011 and Signature Healthcare Brockton Hospital averaging $7,607 on 38 cases during the same time span. That’s a difference of $125.

Good Samaritan Medical Center President and CEO Jeff Liebman said the data show the 215-bed hospital benefits from being part of the 11-hospital Steward Health Care network, helping them lower prices over time.

“It allows you to just refocus some of your efforts on the patient care,” Murphy said.

But Hollon and Altman, of Brandeis, said Medicare charge data is difficult to interpret.

The prices, Hollon said, have little to do with how much the patient might pay to an insurance company.

“They need to refer back to their own individual policy and how the policy treats the hospital,” Hollon said, adding that Brockton Hospital is consistently cheaper under most insurance plans.

Additionally, the prices do not indicate how efficient a hospital is at providing care. The numbers are crafted to make a profit off the varied mix of payers reimbursing the hospital.

“There is a logic to those prices but it’s not what people think it is,” said Harvard University School of Public Health Professor Nancy Kane.

Page 2 of 2 - Routinely, hospitals bill patient care to large health insurance providers like Blue Cross Blue Shield of Massachusetts and Harvard Pilgrim Health Care, inflating costs in some areas to make up for discounts given on insurance plans.

“Each of those (insurance companies) negotiates with every hospital their own payment system, which has very little to do with the extravagant charges that are discussed,” Altman said.

Ultimately, hospitals do not receive the prices revealed in the Medicare data. Medicare, and insurance companies, pay only a portion of the prices listed.

“These are prices,” Kane said. “They have no relationship to the cost to provide the care.”

The prices, Kane said, are based on hospitals trying to make a profit while negotiating with a large private insurance market and accepting government-insured patients.

“It helps people understand how ridiculous and complex our system has become,” Kane said.